For my last week of clinical (ever!) I was on the medical ward at Lewanika General Hospital. I was excited and nervous for this placement, as I had heard from my fellow nursing students that it was a very different experience than the medical wards in Canada. I've spent a lot of time working on medical wards in Canada, and hope to work on one when I graduate. So while I was eager to experience medical nursing in Zambia, I was nervous about what the day would look like and what the patient's diagnoses would be.
When I walked onto the ward, I saw clean, bright spaces and friendly, knowledgeable staff. I instantly felt at home. As we were doing rounds with the doctors and discussing patient diagnoses, I found that a lot of cases were familiar to me, but one patient particularly stood out to me. She was a young woman who was in the hospital with liver failure and ascites. She brought to mind a patient who I cared for in Canada, who also had liver failure and ascites. But while his liver failure was caused by hepatitis (a common cause of liver failure in Canada), her liver failure was caused by bilharzia. Bilharzia is a fluke that lives in freshwater snails, and it can infect people swimming or bathing in infested water by entering the body through the skin or urinary tract. Bilharzia can then infect any organ; for this patient it was her liver. Although it is easily treatable this patient showed signs of major liver damage. I don't know her entire story or how she got to this stage, only that she was now in the hospital.
While the treatment for liver failure and ascites is the same in Canada and Zambia, the resources available in the two countries are very different. This means that these two patients, in their respective countries, will likely have different outcomes.
It really hit me this week how much of a difference resources make, and the options that were available in this situation made it difficult for me to care for this patient. I found that I kept wishing we were in Canada so I could do more - something that I've thought more than once during this practicum. But the healthcare team here continually surprise me with their ingenuity and resilience. They daily care for their patients, in a difficult setting, and they do it with joy. I know that I have a lot to learn from them. Throughout this practicum I have been learning, not just about different diseases and their processes, but also how to keep working in difficult situations and how to solve a problem when it seems like there are no answers. Thinking outside the box has been given a whole new meaning to me.
I don't know what will happen to the young woman I saw at Lewanika. I also don't know what happened to the man in Canada. I do know that all we can do is our best, despite the resources we have in our our hands. Zambia has given me many lessons, but I believe that one of the most important ones is that we are all similar. The details might be different, we might have different accents and nationalities, but at the end of the day we are all just people, living our lives.
I'm so grateful I applied for and was accepted into this international practicum. I have been given a different perspective, and I believe that this experience will shape the rest of my nursing career.